Trauma and Addiction. Building Resiliency in Children And Communities

Transcription

1 Trauma and Addiction Building Resiliency in Children And Communities

2 Meg Harris MSEd, LPC, LSW, CCTP Clinical Supervisor of Trauma Recovery Unit Community Support Supervisor Community Health Worker Supervisor for Infant Mortality Nationally Certified Trauma Counselor Regional Trauma Informed Care Collaborative Representative for the State of Ohio

3 The simultaneous or sequential occurrences of child maltreatmentincluding emotional abuse and neglect, sexual abuse, physical abuse, and witnessing domestic violence-that are chronic and begin in early childhood.

4 A psychologically distressing event that is outside of the range of usual human experience, often involving a sense of intense fear, terror and helplessness Often involve a threat to life or safety: death, other loss, serious injury A perceived sense of threa to self or one s wellbeing

5 Triggers: Signals that act as signs of possible danger, based on historical traumatic experiences and which lead to a set of emotional, physiological, and behavioral responses that arise in the service of survival and safety (e.g., sights, sounds, smells, touch). Triggers are all about one s perceptions experienced as reality. The mind/body connection sets in motion a fight, flight, or freeze response. A triggered individual experiences fear, panic, upset, and agitation.

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7 TRAUMA INFORMED CARE A framework of thinking and interventions that are directed by a thorough understanding of the profound neurological, biological, psychological, and social effects trauma has on an individual recognizing that person s constant interdependent needs for safety, connections, and ways to manage emotions/impulses.

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9 5 Things to know about the opioid epidemic and its effects on children

10 1. Opioid abuse has increased significantly over the last 20 years The amount of prescription opioids sold and the number of people who died due to a prescription opioid overdose have nearly quadrupled in the United States since In 2015, more that 2.5 million people abused or were dependent on opioids (prescription and heroin).

11 2. At least 2 million children annually have a parent who uses illicit drugs, including opioids This can have an impact on any of the following: * Quality of parenting * Childhood neglect * Quality of the parent/child relationship * Trust factors * Children s success in education * Childhood resilience

12 3. Opioid abuse by parents puts children's health and safety at risk Research from the Adverse Childhood Experience s Survey (ACEs) shows that exposure to stress in childhood can have a negative impact on a child s brain; different than that of an adult being exposed to adversity. The impact can lead to chronic maladaptive behaviors and emotions; leading to prolonged health conditions and untimely death.

13 Adolescent Addiction by Senior Year in High School 60% of adolescents have tried alcohol 50% used an illegal drug 30% smoked a cigarette 20% used a prescription drug for nonmedical reason * * * * * * * Only 35% reported discussing substance use with their primary care provider; 65% reported wanting to do so

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16 4. The number of children entering foster care due to parental drug abuse is rising

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18 Linking Trauma to Opioid Addiction 75% of individuals with substance abuse disorders have experienced trauma in their lives; particularly in childhood Percentages are even higher among populations seeking treatment for opioid addiction

19 5. States are responding to the opioid epidemic in diverse and innovative ways Legislation changes in how prescription opiates are managed Implementation of innovative or evidence-based interventions such as family drug courts and family focused residential treatment centers Implementing Crisis Intervention Teams with law enforcement Training First Responders on Trauma Informed Care Strategies

20 The relationship between childhood maltreatment and opiate dependence in adolescence and middle age is significant. This becomes the chicken and the egg: Childhood maltreatment can increase risk of substance dependence later in life & Substance abuse/dependence can lead to childhood maltreatment

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22 Understanding the Relationship between Adolescent Trauma and Substance Abuse one in four children and adolescents in the United States experiences at least one potentially traumatic event before the age of 16 teens who had experienced physical or sexual abuse/assault were three times more likely to report past or current substance abuse than those without a history of trauma up to 59% of young people with PTSD subsequently develop substance abuse problems traumatic stress or PTSD may make it more difficult for adolescents to stop using **National Childhood Traumatic Stress Network

23 Overcoming Challenges Organizationally Providers need to be trained in assessing both trauma and substance use to provide appropriate and seamless services Develop partnerships with local agencies to meet the practical needs of clients when they cannot be met by a single organization (courts/counselors/pcp s/transportation assistance programs/etc.)

24 Overcoming Challenges Model a person-centered, strength-based approach to working with clients. This will help create a cultural shift in how staff and clients interact.

25 Overcoming Challenges Organizationally Training on the impact of secondary trauma and the importance of self-care Communities becoming trauma sensitive and implementing TIC Steering Committees Medical professionals screening for mental health and addiction issues during routine office visits (SBIRT, General Health Questionnaire, Childhood Trauma

26 Interacting with Children during and after a traumatic event: Connections and attachment with others- Help children expand and mature in their social interactions with healthy adult role models. Be that role model. Respectful treatment models the respectful treatment we expect from the child.

27 Interacting and Building Resilience Optimism and positive outlook- Things might seem really grim to a child currently due to choices the adults or peers around them are making. Encourage them to continue making good choices for themselves and remind them when we expect good things to happen there is a better chance they will.

28 Interacting and Building Resilience Play and recreation- The goal of playing, for adults as well as children, is to rebuild our bodies, energy level and enthusiasm. Be involved with children actively.

29 Interacting/Building Resilience Exercise and aerobic activity- Exercise is focused play. Participate in or help create a local branch of organizations, such as the National Police Athletic League (PAL).

30 Interacting and Building Resilience Resiliency and persistence- Bad things happen to everyone. How we respond to the negative things in our life color our perceptions. Encourage children to persist despite the bad things. Show them how challenges can strengthen them.

31 Interacting and Building Resilience Stress reduction- Encourage and teach stress reduction techniques including relaxation. Guide them to research available techniques, experiment with them and use those that are most helpful to them personally.

32 Recovery is supported by addressing trauma: Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.

33 Using TIC to Prevent and Treat Addiction Programs developed to prevent exposure to trauma (Primary Prevention) Promote Resilience (Secondary Prevention) Use Trauma Informed Treatment Approaches to help clients recover and return to productive lives

34 Evidence Based Prevention Strategies Reducing Exposure to Adverse Childhood Experiences Home Visiting Programs: IM Programs Positive Parenting (Triple P) Program: tools to raise healthier children and deal with stressors Parent Child Interaction Therapy: improves quality of parent-child interactions

35 Building Resilience in Children for Therapists and Educators Teach children strategies to calm themselves when under stress Help children plan for positive outcomes by analyzing the cause of their feelings Guide children as they try to identify and understand their own feelings Teach them to seek support when needed Promote development of self-worth and encourage them to take positive opportunities

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38 GET INVOLVED Professional organizations that support Trauma Informed Care State Collaborative Efforts that train in Trauma Informed Care Political Discussions on funding for Trauma Responsive Care/Mental Health and Addiction Services Specialized Court Dockets to facilitate Mental Health/Recovery/Family Systems Trauma and Addiction Assessments in Primary Care Facilities

39 How Vicarious/Secondary Trauma and Compassion Fatigue Can Impact Ones Response to Others in Distress

40 Risk Factors for Compassion Fatigue: Being new to the field Having a history of personal trauma or burnout Working long hours and/or having large caseloads Having inadequate support systems

41 Signs of Compassion Fatigue: Reduced sense of efficacy at work Concentration and focus problems Apathy and emotional numbness Isolation and withdrawal Exhaustion Jaded, bitter pessimism Secretive addictions and self-medicating

42 Putting numbers on the impact of the nation s opioid epidemic is important to measure Harder to measure is the pain of shattered families and trauma of children who find themselves placed in harm's way by the very people they love and count upon for protection.

43 References CSB levy increase to help record number of kids in foster care PSCAO Public Children Services of Ohio: November 13, 2017 CDC s Adverse Childhood Experiences Study (acestudy.org) Child Trends: National Institute of Health: The Relationship Between Trauma and Addiction: Opiate Treatment Centers of America (otcoa.com) In Harm s Way: Children and Drug Epidemics-Innocent Victims: Milwaukee Journal Sentinal: Crocker Stephenson & Ashley Luthern, May 11, 2017;

44 References National Child Traumatic Stress Network: Making the Connection: Trauma and Substance Abuse ( Trauma-Informed Care Resources Guide ( Trauma Informed Policing ( Child Trauma Academy: Dr. Bruce Perry/childtrauma.org SAMHSA: Substance Abuse and Mental Health Services Administration Ohio Department of Mental Health and Addiction Services: National Institute for the Clinical Application of Behavioral Medicine--Working with the Sensations that Trigger Traumatic Memories: Bessel van der Kolk

45 References Campaign for Trauma Informed Policy and Practice; Policy Brief, June 2017, Number 1; National Council for Behavioral Health November, 2017

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